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Thursday, December 18, 2014

NHS Privatisation: looking at the Tory/LibDem case

The Tories are mounting a very energetic counter-attack against any accusation that the NHS is being privatised. Here are their defensive arguments, in italics, followed by the prosecution case.

It is not being privatised. Privatisation means the sale of a business that was previously owned by the government. The NHS is not being sold as a totality, there is no share issue, therefore it is not being privatised.This is like coming home and finding a man filling his bag with your cutlery. You say, "Stop burgling my house". He says, "I'm not burgling your house, I'm just helping myself to a few bits of cutlery that are in this drawer in your house". Do you settle down to discuss semantics with the burglar, or do you call the police?

We are not privatising the NHS, we are franchising out some services.Franchise is an authorization granted by one enterprise to another agent to act on behalf of the original enterprise in one area of its operations. In that the original enterprise is a public body, and the franchisees in question are private bodies, this confirms that privatisation is taking place.

Arguments 1 and 2 are based on semantics.

The private sector has won 41% of contracts awarded via competitive tender against just 30% for NHS providers, because CCGs are obliged to give to the lowest bidder. Privateers can offer a "loss leader", cut workers and reduce their wages, and once installed can put up their prices.

Labour started it. They privatised Hinchingbrooke Hospital. So much the worse for Labour.

The HCSA puts doctors in charge of commissioning.In theory and at first. Many GPs are quitting CCG places because of the burden of managerialisationism, and frustration at having to listen to professional managers telling them what they must do. Financial "Consultants" are creaming £640million a year off the NHS.

The Health and Social Care Act is a wonderful success. It has got rid of 19,000 managers, saving money for clinical work.*In fact, the 19,000 were mainly clinicians with some management responsibility. *There are now 440 bodies managing the service instead of the 163 there were in 2010.(Much of this is because of the huge managerial and clinical time wasted on drawing up tenders and running tendering processes.)*Overall the Lansley reforms cost the NHS £3billion, and have meant that pay rises have been held back, resulting in recent strikes. Under the Tories:*waiting times have gone up*outcomes have got worse*GPs and A&E departments are overwhelmed*bed-blocking has increased.*Senior Tories have now admitted that the HSCA was a mistake. They did not understand what Lansley was up to.

It is the GP led Clinical Commissioning Groups (CCGs) who will decide whether to engage an NHS organisation or a private company to take on contracts.CCGs are obliged to take the cheapest offer. Private corporations can make cheap offers as a loss-leader, and put up their prices later.

The Transatlantic Trade and Investment Partnership (TTIP) "could have no impact on the UK's sovereign right to make changes to the NHS" according to the EU's chief negotiator.Read the line carefully. The accusation is that TTIP means that the NHS will by law be open to bids by private companies. The statement above does not in any way deny that will happen.

Note: this is a vast subject, and this post will be expanded to take on further debate. I will copy any useful comments added below.